RESUMO
Objective: The purpose of our comparative study is whether the delayed primary skin closure of contaminated and dirty abdominal incision reduces the rate of surgical site infection, and the rate of morbidity as compared with the primary skin closure
Study Design: Experimental / Randomized study
Place and Duration of Study: This study was carried out at National Institute of Child Health Karachi from February 2007 to July 2007
Materials and Methods: A total of 60 patients of pediatric age group were included .They have randomized to have their surgical incision [skin and subcutaneous tissue] either primarily closed or left opened with the pyodine soaked gauze packing and loose stitches applied for delayed primary closure which were tied on 4th post of day of wound closure
A wound was considered infected if pus discharged from the incision site
The main out come measured were the incidence of wound infection and the length of hospital stay
Results: This study revealed that the incidence of wound infection was considerably high in those contaminated wound where primary closure was done in 46.67% 18 out of 60 patients, hence increased morbidity with prolonged hospital stay while in delayed primary closure wound infection was 33.33% 10 out of 60 patients
Conclusion: This study revealed that method of delayed primary closure without skin stitches is better than the primary wound closure technique in contaminated abdominal wounds
RESUMO
A 12-year-old boy referred from another facility after sustaining stray bullet injury to chest on left side with no exit wound. He remained stable through out although chest intubation was done in referring hospital. In our Emergency Room he remained well therefore shifted to surgical unit. Investigations revealed bullet in pericardial cavity. It was decided to remove the bullet on elective basis. Surgery was deferred at the request of parents. Six months later child was operated. Initially thoracoscopy was performed but it was converted to open thoracotomy as bullet could not be identified. It was then retrieved easily from paricardial cavity. Post operative recovery was uneventful